1912 Oak Circle RES20-0001 Interior Non Bearing Parition Walls (--.1`--.--;',:!,-/ RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES20-0001
,�
/l 800 SEMINOLE ROAD ISSUED: 1/3/2020
N' '=y'" ryATLANTIC BEACH. FL 32233 EXPIRES: 7/1/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1912 OAK CIR RESIDENTIAL ALTERATION INTERIOR NON BEARING $1000.00
RESIDENTIAL PARTITION WALLS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 1254 SELVA MARINA UNIT
12A
COMPANY: ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: ZIP:
COOK THOMAS J 1912 OAK CIR ATLANTIC BEACH FL 32233-4506
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
_J
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $60.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000 208 0600 0 $2.00
TOTAL:$94.00
Issued Date: 1/3/2020 1 of 2
1.A1.1 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road CSU )
�: Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 I z
' 0111 . E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:
Z 0),„,* e I 7 Department review required Ye No
:uilding_
Applicant: 1 .-__)- C.0 C.0 I'\ Q r— `'anning &Zoning
_/ I Tree Administrator
Project: 1 n 7 BY Pa t i W,r% Public Works
Public Utilities
i vl CTa kr-itS .e— Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
I _
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied. I 'Not applicable
(Circle one.) Comments:
UILDN0
PLANNING &ZONING x 1
Reviewed by: / ' Date: / –c?-'9-020
TREE ADMIN. Second Review: Approved as revised. Denie .
pp ❑ ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
.rs''/' BuildingPermit Application
OFFICE COPY Updated l0/9/18
pp
r City of Atlantic Beach Building Department **ALL INFORMATION
+1. 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
-• u,sp`xr IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us j�
Job Address: /912 0/7k d/AfcE' 4•TtaNrl C ;3c"4C,y ,y, Permit Number: R ES Z C" 000 i 1
Legal Description 36b`f-CPC' •.)-S -a'r c S4-"I mA,Z/,'A 6""7!i-,ti I-tY Ii RE# N/%4
Valuation of Work(Replacement Cost)$ %e c 0,<<.<<.0,
<. Heated/Cooled SF Ae7A Non-Heated/Cooled ✓ (6-.4a..460
• Class of Work: ❑New ❑Addition 2/Alteration ❑Repair OMove [Memo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial residential
• If an existing structure,is a fire sprinkler system installed?:. DYes l o
• Will tree(s) be removed in association with proposed prosect?[Nes(must submit separate Tree Removal Permit) I3<o
Describe in detail the type of work to be performed: r3r,i,L.,3 L LI ,/0,,e • V - -
- EV,5:7,A11. &, Jt[,E. 5'. F 47Ti4rHL%_ P. ."0-w.•.-t;.. W C
U c
ZN
Florida Product Approval# Ai 4 - for multiple products use product appraXa[ prrrjr z (i
Property Owner Information a U ct 0 `
Name 7154-1Cook Address 19/1 cA/4c'iA1« n Lto 0 ti
City A72./ crit i3.-- c.w State FL- Zip 3 I-13 3 Phone /-yo 1- FfSy'%y6d7 al 0 2 F.
E-Mail *AI(0 cd/cvf e.• :Mncf;ny,ec.v, W Q U C
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) N/A d < p
Contractor Information -,..,.0 (ett,,,:/=:z •4--,g-r%3 <2.0%),-ec47'404> O < 2 Q C
Name of Company Qualifying Agent � }.. � H
Address City State Zip o Q I- w
Office Phone Job Site Contact Number LI. O rr 2
State Certification/Registration# E-Mail 8 a Cr a
}
Architect Name&Phone#
5 I— W Q LL
Engineer's Name&Phone# W U o7 w
Workers Compensation Insurer --'' OR Exempt❑ Expiration Date j cc
Application is hereby made to obtain a permit to do the work and,
,--installations as indicated.I certify that no work or install on has i.
cr
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regTating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies, or
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECQ D�Y U' •TICE OF COMMENCEMENT.
.14 )f
►..
(Si ature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this 02 day of Signed and sworn to(or affirmed)before me this day of
JCInUai , 2620 „3 QS 3 . C ODIC ,by
Heather V)' 7 /
4',11fr.'� (Signature of Notary) 4 (Sign re of Notary)
•�
State of Florida
:1/40yiMy Commission Expires 02/01/2021
[ 1 pers9nagRIOSSIQ4410.GG 68713 [ )Personally Known OR
[ oduced Identificatiop " �����{ [ 1 Produced Identification
Type of Identification: fUnv`G Dn ve6 L1 wr' Type of Identification:
OFFICECOPS **ALL INFORMATION
Owner Builder Affidavit HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
2 800 Seminole Rd, Atlantic Beach, FL 32233
91119/ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: �So � <DO6/
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1"CONSTRUCTION CONTRACTING" REQUIRES
OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED
FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER
OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A
LICENSE.
YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE
CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
III. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: !H7 O/ ( de /ti.
Owner Name: -1—A,yY►ulti 4 li,tt< Phone Number: `r�, -�35? - (666
66
Mailing Address: 11 ) d}j)< Cf tCity:-l2 r I n
/t��ti lr �cirh- State: rt_ 2—)
Notarized Signature of Owner Sthytit4A
The foregoing instrument was acknowledged bef re me this OZ day of jkfq)C (\/ , 202.D, in the State of Florida, County
of DuVc11
Heather Mooney Signature of Notary Public Y V(7). 1/)
StateFlorida [ ] Personally Known OR [ roduced Identification
My Commissionon Expires 02!01/2021
Commission No.GG 68713 •
yp I on c. c1 !Or \e XS L L�S-e-
T e of Identification:
Updated 10/24/18
EXISTING HOME OFFICE COPY
EXISTING FRAME WALL (NO ;
CHANGES, THIS PERMIT)
iEXISTIN
II 2848 GAR. 0
1 DOOR IN- N
"TO HSE.
a STORAGE
! z 8'-4" FLAT CEILING.
Zi-
1
z� — z�
ac
a� / 4'-4' / 13'-8' X aUi
`rico NEW NON-BEARING FRAME WALLS: via)
m= NEW 3048 2"X4' WD. STUDS AT 14' O.C. (MAX.) a?i
di-cri OPSNIDNG W/I/2" DRYWALL BOTH SIDES. Ui-
k-ILL1 Owcn< _----- v)¢
WU I WU
BICYCLES AND LAWN TOOLS STORAGE °D
' ! 8'-4' FLAT CEILING. '-
I I
I 1
i1 !
; IC W. X l'-0" H. EXISTING OVERHEAD, STEEL GAR. DR.
P 04 RTITIOil WA .1
ADDITION! ON1.Y
SCALE: 1/4' = I'-O'
NOTE: EVERYTHING SHOWN IN LIGHT, DASHED LINES IS EXISTING.